Reflections: A Somalia mission experience

Reports about The Horn of Africa Famine Crisis in 2011 flooded our news bulletins and newspapers. Yet the nations of the world failed to respond and alleviate the unfolding disaster. In August 2011, the Gift of the Givers Foundation mobilised what was to become the largest humanitarian mission ever conducted by an African organisation. Almost a year later, the effort continues, changing the face of disaster medicine as we know it

Health-seeking behaviours by gender among adolescents in Soweto, South Africa

KIMBACKGROUND: Adolescents are an important age-group for preventing disease and supporting health yet little is known about their health-seeking behaviours. OBJECTIVE: We describe socio-demographic characteristics and health-seeking behaviours of adolescents in Soweto, South Africa, in order to broaden our understanding of their health needs. DESIGN: The Botsha Bophelo Adolescent Health Study was an interviewer-administered cross-sectional survey of 830 adolescents (14-19 years) conducted in Soweto from 2010 to 2012. Health-seeking behaviours were defined as accessing medical services and/or being hospitalised in the 6 months prior to the survey. Chi-square analysis tested for associations between gender, other socio-demographic and behavioural characteristics, and health-seeking behaviours. RESULTS: Of 830 adolescents, 57% were female, 50% were aged 17-19 years, 85% were enrolled in school, and 78% reported experiencing medium or high food insecurity. Males were more likely than females to report sexual debut (64% vs. 49%; p<0.0001) and illicit drug use (11% vs. 3%; p<0.0001). Approximately 27% (n=224) and 8% (n=65) reported seeking healthcare or being hospitalised respectively in the previous 6 months, with no significant differences by gender. Services were most commonly sought at medical clinics (75%), predominantly because of flu-like symptoms (32%), followed by concerns about HIV (10%). Compared to females, males were more likely to seek healthcare for condom breakage (8% vs. 2%; p=0.02). Relative to males, a significantly higher proportion of females desired general healthcare services (85% vs. 78%; p=0.0091), counselling (82% vs. 70%; p<0.0001), and reproductive health services (64% vs. 56%; p=0.02). CONCLUSIONS: A quarter of male and female adolescents accessed health services in the 6 months prior to the interview. Adolescents reported a gap between the availability and the need for general, reproductive, and counselling services. Integrated adolescent-friendly, school-based health services are recommended to bridge this gap

Gaucher disease: A cause of massive splenomegaly in a 15-year-old black African male

Patients with Gaucher disease (GD), a rare autosomal recessive lysosomal storage disease, commonly present to paediatricians with massive splenomegaly. While the diagnosis and management of patients with this chronic multisystem disorder has evolved significantly in recent years, the initial diagnosis represents a challenge. We describe the case of a 15-year-old black African male who presented with abdominal distension, delayed growth and fatigue. Initial laboratory studies revealed severe anaemia (haemoglobin concentration 8 g/dL) and moderate thrombocytopenia (platelet count 80 × 109/L). A computed tomography scan of the abdomen showed an enlarged liver of 173 mm and massive splenomegaly of 27 mm. The diagnosis of GD was confirmed by reduced beta-glucocerebrosidase activity and heterozygous mutations in the GBA1 gene. The patient was managed at a dedicated paediatric haematology unit with enzyme replacement therapy and regular clinical, biochemical and radiological monitoring

Challenges around COVID-19 at a tertiary-level healthcare facility in South Africa and strategies implemented for improvement

SARS-CoV-2 has resulted in a global pandemic within months following its initial detection. South Africa (SA), like many other countries, was not prepared for the impact this novel infection would have on the healthcare system. In this paper, the authors discuss the challenges experienced while facing COVID-19 at a tertiary-level institution in Gauteng province, SA, and the dynamic strategies implemented to deal with the epidemic

Held to ransom - CMV treatment in South Africa

Cytomegalovirus is a multi-systemic infection reactivated in the immunocompromised. Diagnosis and treatment are prohibitively costly in sub-Saharan Africa, and efforts need to be made for their price reduction to support the expanding highly active antiretroviral treatment programme in the region

A hot and fast ultra-stripped supernova that likely formed a compact neutron star binary

Compact neutron star binary systems are produced from binary massive stars through stellar evolution involving up to two supernova explosions. The final stages in the formation of these systems have not been directly observed. We report the discovery of iPTF 14gqr (SN 2014ft), a type Ic supernova with a fast-evolving light curve indicating an extremely low ejecta mass (≈0.2 solar masses) and low kinetic energy (≈2 × 10^(50) ergs). Early photometry and spectroscopy reveal evidence of shock cooling of an extended helium-rich envelope, likely ejected in an intense pre-explosion mass-loss episode of the progenitor. Taken together, we interpret iPTF 14gqr as evidence for ultra-stripped supernovae that form neutron stars in compact binary systems

Preparing for Advanced LIGO: A Star–Galaxy Separation Catalog for the Palomar Transient Factory

The search for fast optical transients, such as the expected electromagnetic counterparts to binary neutron star mergers, is riddled with false positives (FPs) ranging from asteroids to stellar flares. While moving objects are readily rejected via image pairs separated by ~1 hr, stellar flares represent a challenging foreground, significantly outnumbering rapidly evolving explosions. Identifying stellar sources close to and fainter than the transient detection limit can eliminate these FPs. Here, we present a method to reliably identify stars in deep co-adds of Palomar Transient Factory (PTF) imaging. Our machine-learning methodology utilizes the random forest (RF) algorithm, which is trained using > 3 x 10^6 sources with Sloan Digital Sky Survey (SDSS) spectra. When evaluated on an independent test set, the PTF RF model outperforms the SExtractor star classifier by ~4%. For faint sources (r' ≥ 21 mag), which dominate the field population, the PTF RF model produces a ~19% improvement over SExtractor. To avoid false negatives in the PTF transient-candidate stream, we adopt a conservative stellar classification threshold, corresponding to a galaxy misclassification rate of 0.005. Ultimately, 1.70 x 10^8 objects are included in our PTF point-source catalog, of which only ~10^6 are expected to be galaxies. We demonstrate that the PTF RF catalog reveals transients that otherwise would have been missed. To leverage its superior image quality, we additionally create an SDSS point-source catalog, which is also tuned to have a galaxy misclassification rate of 0.005. These catalogs have been incorporated into the PTF real-time pipelines to automatically reject stellar sources as non-extragalactic transients